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NPI Code Detail

MEDICARE: JOSEPH REHABILITATION CENTER, LLC

MEDICARE: JOSEPH REHABILITATION CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13104A0625XAssisted Living Facility (Mental Illness)IL
2315P00000XIntellectual Disabilities Intermediate Care FacilityIL

General Provider Information

NPI Number : 1316187446
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSEPH REHABILITATION CENTER, LLC
Provider Business Mailing Address
First Line : 2 OLYMPUS DR
Second Line :
City : TINLEY PARK
State : IL
Zip : 60477-4827
Country : US
Telephone Number : 708-420-3250
Fax Number : 708-429-5868
Provider Business Practice Location Address
First Line : 2 OLYMPUS DR
Second Line :
City : TINLEY PARK
State : IL
Zip : 60477-4827
Country : US
Telephone Number : 708-420-3250
Fax Number : 708-429-5868
Authorized Official
Title or Position : CEO
Name : DR. JOSEPH ABIODUN BALOGUN
Credential : PHD PT
Telephone Number : 708-420-3250
Provider Enumeration Date : 03/02/2009
Last Update Date : 03/02/2009

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Directions to “JOSEPH REHABILITATION CENTER, LLC ” Practice Location

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